中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
4期
368-371
,共4页
史静琤%孙振球%莫显昆%蔡太生
史靜琤%孫振毬%莫顯昆%蔡太生
사정쟁%손진구%막현곤%채태생
前列腺增生%模型,统计学%肾上腺素能α拮抗剂
前列腺增生%模型,統計學%腎上腺素能α拮抗劑
전렬선증생%모형,통계학%신상선소능α길항제
Prostatic hyperplasia%Models,statistical%Adrenergic alpha-antagonists
目的 比较α1受体阻滞剂、5α还原酶抑制剂和联合治疗良性前列腺增生(BPH)的疗效,并探讨多水平统计模型在BPH药物治疗医疗结局评价中的应用. 方法 采用实际临床试验设计(PCT)对接受α1受体阻滞剂、5α还原酶抑制剂和联合治疗(即α1受体阻滞剂与5α还原酶抑制剂合用)的BPH患者随访4年,采用多水平模型比较患者国际前列腺症状评分(IPSS)和BPH患者生活质量评分(BPH-QLS). 结果 IPSS评分和BPH-QLS评分的组内相关系数分别为0.6136和0.6946,研究数据存在明显的层次结构.在随访期内,随着治疗时间延长,各药物治疗组IPSS评分和BPH-QLS评分均有改善,呈曲线变化趋势(P＜0.05).α1受体阻滞剂组、5α还原酶抑制剂组与联合治疗组比较,变化趋势差异无统计学意义(均P＞0.05). 结论 对于生活质量受到一定影响的中度症状BPH患者,α1受体阻滞剂、5α还原酶抑制剂和联合治疗方案均能明显改善症状、提高生活质量,且在4年随访期内效果相当.在BPH治疗的医疗后果评价研究中,多水平统计模型比传统的统计分析方法更为合适和精确.
目的 比較α1受體阻滯劑、5α還原酶抑製劑和聯閤治療良性前列腺增生(BPH)的療效,併探討多水平統計模型在BPH藥物治療醫療結跼評價中的應用. 方法 採用實際臨床試驗設計(PCT)對接受α1受體阻滯劑、5α還原酶抑製劑和聯閤治療(即α1受體阻滯劑與5α還原酶抑製劑閤用)的BPH患者隨訪4年,採用多水平模型比較患者國際前列腺癥狀評分(IPSS)和BPH患者生活質量評分(BPH-QLS). 結果 IPSS評分和BPH-QLS評分的組內相關繫數分彆為0.6136和0.6946,研究數據存在明顯的層次結構.在隨訪期內,隨著治療時間延長,各藥物治療組IPSS評分和BPH-QLS評分均有改善,呈麯線變化趨勢(P＜0.05).α1受體阻滯劑組、5α還原酶抑製劑組與聯閤治療組比較,變化趨勢差異無統計學意義(均P＞0.05). 結論 對于生活質量受到一定影響的中度癥狀BPH患者,α1受體阻滯劑、5α還原酶抑製劑和聯閤治療方案均能明顯改善癥狀、提高生活質量,且在4年隨訪期內效果相噹.在BPH治療的醫療後果評價研究中,多水平統計模型比傳統的統計分析方法更為閤適和精確.
목적 비교α1수체조체제、5α환원매억제제화연합치료량성전렬선증생(BPH)적료효,병탐토다수평통계모형재BPH약물치료의료결국평개중적응용. 방법 채용실제림상시험설계(PCT)대접수α1수체조체제、5α환원매억제제화연합치료(즉α1수체조체제여5α환원매억제제합용)적BPH환자수방4년,채용다수평모형비교환자국제전렬선증상평분(IPSS)화BPH환자생활질량평분(BPH-QLS). 결과 IPSS평분화BPH-QLS평분적조내상관계수분별위0.6136화0.6946,연구수거존재명현적층차결구.재수방기내,수착치료시간연장,각약물치료조IPSS평분화BPH-QLS평분균유개선,정곡선변화추세(P＜0.05).α1수체조체제조、5α환원매억제제조여연합치료조비교,변화추세차이무통계학의의(균P＞0.05). 결론 대우생활질량수도일정영향적중도증상BPH환자,α1수체조체제、5α환원매억제제화연합치료방안균능명현개선증상、제고생활질량,차재4년수방기내효과상당.재BPH치료적의료후과평개연구중,다수평통계모형비전통적통계분석방법경위합괄화정학.
Objective To compare the efficacy of α1 adrenergic receptor blocker,5α-reductase inhibitor or combination therapy in benign prostatic hyperplasia (BPH),and to explore the application of multi-level statistical model in assessment of BPH treatments.Methods Pragmatic clinical trials (PCT) design was used.BPH patients received drug therapy including α-adrenergic receptor blocker,5α reductase inhibitor,and combination therapy were followed up for 4 years.Multilevel statistical model was used to compare the scores of international prostate symtom score(IPSS) and BPH qality of life scale(QLS) among the 3 therapeutic regimens.Results The intra class correlation coefficients of I-PSS and BPH-QLS were 0.6136 and 0.6946 respectively,which indicated that both data were hierarchical structured.During the follow-up period,scores of IPSS and BPH-QLS were improved along with the drug therapy in 3 regimens.There was curve relationship between treatment time and IPSS and BPH-QLS scores in 3 regimens (all P＜0.05),and there was no significant differences in the trend of curves between the 3 regimens (P＞0.05).Conclusions For BPH patients with moderate symptoms bothering the quality of life,α-adrenergic receptor blocker,5α-reductase inhibitor,or combination therapy are significantly effective in reducing symptoms and improving quality of life.There are no efficacy differences among the 3 drug therapy during the 4-years follow-up.Compared with traditional analysis,multilevel statistical model is a more suitable and precise method for assessment of BPH treatments.
